AIM: To compare the value of endoscopic retrograde cholangiography (ERC) and standard T2-weighted magnetic resonance cholangiography (MRC) in the evaluation process as adult-to-adult right lobe living donor liver tran...AIM: To compare the value of endoscopic retrograde cholangiography (ERC) and standard T2-weighted magnetic resonance cholangiography (MRC) in the evaluation process as adult-to-adult right lobe living donor liver transplantation (LDLTx) demands a successful outcome, and exact knowledge of the biliary tree is implicated to avoid biliary complications, postoperatively.METHODS: After starting the LDLTx program, 18 liver transplant candidates were selected for LDLTx by a stepwise evaluation process. ERC and standard T2-weighted MRC were performed to evaluate the biliary system of the donor liver. The anatomical findings of ERC and MRC mapping were compared using the Ohkubo classification. RESULTS: ERC allowed mapping of the whole biliary system in 15/15 (100%) cases, including 14/15 (93.3%) with biliary variants while routine MRC was only accurate in 2/13 (15.4%) cases. MRC was limited in depicting the biliary system proximal of the hepatic bifurcation. Postoperative biliary complications occurred in 2 donors and 8 recipients. Biliary complications were associated with Ohkubo type C, E or G in 6/8 recipients, and 2/3 recipients with biliary leak received a graft with multiple (≥2) bile ducts. CONCLUSION: Pretransplant ERC is safe and superior over standard MRC for detection of biliary variations that occur with a high frequency. However, precise knowledge of biliary variants did not reduce the incidence of postoperative biliary complications.展开更多
Summary: The purpose of this study was to evaluate relative regional blood volume (rCBV) in meningioma and compare the utility of reconstruction using both gradient-echo sequence and echo-planar-imaging (EPI) sequence...Summary: The purpose of this study was to evaluate relative regional blood volume (rCBV) in meningioma and compare the utility of reconstruction using both gradient-echo sequence and echo-planar-imaging (EPI) sequence.Eighteen patients with meningiomas were studied on a Siemens 1.5-T scanner. During the gradient-echo sequence (n=12) and EPI sequence (n=6), a bolus ^(0.2 mmol/kg) of Gd-DTPA was injected mechanically with a flow rate of 5 ml/second. Image processing of dynamic data was performed on a pixel-by-pixel basis. The ratio of tumor rCBV/gray matter rCBV was 3.01±1.18 (3.07 ± 1.39 in gradient sequence and 2.84 ± 0.94 in EPI sequence). The ratio of gray matter/ white matter as the reference tissue had a mean of 2.79 ± 0.76 using the FLASH sequence, and a mean of 3.04 ± 1.31 using EPI. These differences were not statistically signifcant (P>0.5, t-test). According to the ratio of tumor rCBV/gray matter rCBV, a mean value, 14.5 ml/100 g, of rCBV in meningiomas was calculated. Compared with gray matter, increased inhomogeneous rCBV was observed in meningioma. Based on the two different sequences, no bias can be observed in our rCBV reconstruction.展开更多
文摘AIM: To compare the value of endoscopic retrograde cholangiography (ERC) and standard T2-weighted magnetic resonance cholangiography (MRC) in the evaluation process as adult-to-adult right lobe living donor liver transplantation (LDLTx) demands a successful outcome, and exact knowledge of the biliary tree is implicated to avoid biliary complications, postoperatively.METHODS: After starting the LDLTx program, 18 liver transplant candidates were selected for LDLTx by a stepwise evaluation process. ERC and standard T2-weighted MRC were performed to evaluate the biliary system of the donor liver. The anatomical findings of ERC and MRC mapping were compared using the Ohkubo classification. RESULTS: ERC allowed mapping of the whole biliary system in 15/15 (100%) cases, including 14/15 (93.3%) with biliary variants while routine MRC was only accurate in 2/13 (15.4%) cases. MRC was limited in depicting the biliary system proximal of the hepatic bifurcation. Postoperative biliary complications occurred in 2 donors and 8 recipients. Biliary complications were associated with Ohkubo type C, E or G in 6/8 recipients, and 2/3 recipients with biliary leak received a graft with multiple (≥2) bile ducts. CONCLUSION: Pretransplant ERC is safe and superior over standard MRC for detection of biliary variations that occur with a high frequency. However, precise knowledge of biliary variants did not reduce the incidence of postoperative biliary complications.
文摘Summary: The purpose of this study was to evaluate relative regional blood volume (rCBV) in meningioma and compare the utility of reconstruction using both gradient-echo sequence and echo-planar-imaging (EPI) sequence.Eighteen patients with meningiomas were studied on a Siemens 1.5-T scanner. During the gradient-echo sequence (n=12) and EPI sequence (n=6), a bolus ^(0.2 mmol/kg) of Gd-DTPA was injected mechanically with a flow rate of 5 ml/second. Image processing of dynamic data was performed on a pixel-by-pixel basis. The ratio of tumor rCBV/gray matter rCBV was 3.01±1.18 (3.07 ± 1.39 in gradient sequence and 2.84 ± 0.94 in EPI sequence). The ratio of gray matter/ white matter as the reference tissue had a mean of 2.79 ± 0.76 using the FLASH sequence, and a mean of 3.04 ± 1.31 using EPI. These differences were not statistically signifcant (P>0.5, t-test). According to the ratio of tumor rCBV/gray matter rCBV, a mean value, 14.5 ml/100 g, of rCBV in meningiomas was calculated. Compared with gray matter, increased inhomogeneous rCBV was observed in meningioma. Based on the two different sequences, no bias can be observed in our rCBV reconstruction.
